Rini Purwanti Sekretaris PD IPDI Jatim

Transcription

1 Kidney Emergency Rini Purwanti Sekretaris PD IPDI Jatim

2 overview The kidneys are a pair of small ( about the size of your fist-sized ), bean shaped organs that lie on either side of your spine, located just below the lowest rib they filter by-products and toxins from the blood and preserve the balance of bodily fluids and electrolytes

3 What s an emergency Kidneys? When the kidneys partly or completely lose their ability to filter water and waste from the blood. This condition also known as Acute Kidney Failure

4 What cause Acute Kidney Failure? Prerenal: Problems affecting the flow of blood before it reaches the kidneys Postrenal: Problems affecting the movement of urine out of the kidneys Renal: Problems with the kidney itself that prevent proper filtration of blood or production of urine

5 Acute Kidney Failure Symptoms Decreased urine production Body swelling Problems concentrating Confusion fatigue Lethargy Nausea, vomiting Diarrhea Abdominal pain Metallic taste in the mouth

6 Become emergency.if. Change in awakening) level of consciousness (extreme sleepiness or difficulty Fainting Chest pain Difficulty breathing Extremely high blood pressure ( hypertension ), greater than 180/100 Severe nausea and vomiting Severe bleeding (from any source) Severe weakness Inability to urinate

7 Diagnosis.. Blood test laboratory Levels of urea (blood urea nitrogen [BUN]) and creatinine are high in kidney failure. This is called Azotemia. Electrolyte levels in the blood may be abnormally high or low because of improper filtering. When the duration and severity of kidney failure is severe, the red blood cell count may be low. This is called Anemia. Urine test When kidney tissue is injured, protein and desirable substances may be inappropriately excreted in the urine. Ultrasound If the diagnosis is not certain after laboratory tests, an ultrasound of the kidneys and bladder may be done to help reveal signs of specific causes of kidney failure.

8 Treatment The first goal is to pinpoint the exact cause of the kidney failure, as that will partly dictate the treatment Secondly, the degree to which accumulating wastes and water are affecting the body will impact treatment decisions about medications and the need for dialysis.

9 Acute Kidney Failure Medical Treatment Treatment is focused on removing the cause of the kidney failure. Medications and other products the patient ingests will be reviewed. Any that might harm the kidneys will be eliminated or the dose reduced.

10 Other treatment.. Correct dehydration: Intravenous fluids, with electrolyte replacement if needed Fluid restriction: For those types of kidney failure in which excess fluid is not appropriately eliminated by the kidneys Increase blood flow to the kidney: Usually related to improving heart function or increasing blood pressure Correct chemical (electrolyte) abnormalities: Keeps other body systems working properly

11 If the treatment doesn t respond They will need to undergo dialysis. Dialysis is done by accessing the blood vessels through the skin (hemodialysis) or by accessing the abdominal cavity through the lining that encases the abdominal organs (peritoneal dialysis).

12 Prognosis... On long-term follow-up (1 to 10 years), approximately 12.5% of survivors of acute renal failure require dialysis and 19% to 31% of them have chronic kidney disease. The in-hospital mortality (death) rate for acute kidney failure is 40% to 50%. The mortality rate in patients in intensive care (ICU) settings with acute kidney failure that requires dialysis is 70% to 80%

13 Summary